Overview
The aim of the proposed study is to perform a comparative pilot, randomized controlled trial of hip arthroscopy versus definitive total hip arthroplasty (THA) for the treatment of early hip osteoarthritis (Tönnis Grade 1-2) in patients between the ages of 40-60 years.
Description
The purpose of this study is to conduct a randomized trial to compare hip arthroscopy to THR and estimate the long-term cost-effectiveness. Specifically, we aim to:
- Estimate the magnitude of the between-groups difference in the primary outcome (Hip Dysfunction and Osteoarthritis Outcome Score - HOOS);
- Evaluate the clinical and cost-effectiveness of early definitive THA compared to arthroscopy for early-stage hip OA at 1-year postoperative;
- Estimate the lifetime cost-effectiveness of arthroscopy vs THA using a Markov model; and
- Identify imaging and biomechanical predictors of outcomes following hip arthroscopy
Eligibility
Inclusion criteria:
- Between the ages of 40-60 years at the time of surgery.
- Radiographic evidence of mild to moderate hip OA (Tönnis Gr 0 with MRI chondral wear, Tönnis Gr 1 and 2).
- Patients must have completed ≥3 months of non-operative management with ongoing symptoms.
Exclusion criteria:
- Advanced OA, defined as <2 mm joint space (Tönnis Gr 3) or those with acetabular or femoral head cysts.
- Patients who are pregnant or may become pregnant around the time of surgery.
- Prior arthroplasty of the contralateral hip.
- Current or prior hip dysplasia (defined by a lateral centre edge angle of <20 degrees).
- Acetabular protrusio or coxa profunda, making arthroscopic access unsafe/unfeasible.